Healthcare Provider Details

I. General information

NPI: 1972422251
Provider Name (Legal Business Name): MISS AMORETTE RENEE WALLICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 HIGH ST
OROVILLE CA
95965-4643
US

IV. Provider business mailing address

980 HIGH ST
OROVILLE CA
95965-4643
US

V. Phone/Fax

Practice location:
  • Phone: 916-642-7800
  • Fax: 888-870-9642
Mailing address:
  • Phone: 916-642-7800
  • Fax: 888-870-9642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: